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1.  Reaching Out:  Male and Female Sex Workers
2.  Prevention policies should be directed at the behaviour of those who display the highest risk - Debate.
3.  Caring for the caregivers
4.  Gay Men and Summation
Europe Lobbies Parliamentary Assembly on Lesbian and Gay Issues

Gay Men and Summation

mong gay and other homosexually active men, the importance of the careful local monitoring of sexual practice was emphasised, with research revealing the absence of clear and universal trends.

Comparative work in London, Sydney / Melbourne and Vancouver, for example, suggests no clear-cut relationship between treatment optimism and unprotected anal sex with casual or occasional partners.

Evidence does, however, continue to accumulate about the risks in oral sex, and those faced by both younger and (importantly) older gay men in relationships.  We need for the continual updating of prevention messages for these groups - we simply cannot afford to assume that the approaches that have worked in the past will work in the future.

There were markedly fewer presentations on gay and homosexually active men at this conference, even though epidemics related to male-to-male transmission of HIV are by no means over in the developed world.

There was, however, an encouraging increase in papers from developing countries on men who have sex with men, including regional reviews of Latin America and the Caribbean, and papers from Africa, South Asia, South-east Asia, the Pacific, Eastern Europe and the Mediterranean.

While excellent interventions for gay men and other homosexually or bisexually active men were reported, there was a strong sense that less-than-optimal global sharing of good prevention practice among these populations of men was slowing progress.  There is a real opportunity to ensure that still-growing MSM epidemics in the developing world never repeat the experience of Western gay communities.

Some outstanding issues

I want to conclude by highlightingsome of the research issues that might be useful for social science to address before Barcelona.  They include:

  • Explaining why denial encourages some people to persist in believing (despite clear evidence to the contrary) that HIV is not the cause of AIDS
  • Understanding of the role of 'at home' and 'migrant' situations as determinants of HIV-related vulnerabilities of women and men
  • Developing more tightly focused interventions with especially vulnerable groups (e.g. ethnic minorities) and newly perceived vulnerable groups (e.g. young homosexually active men in developing countries)
  • Understanding and overcoming the barriers to scaling up the kinds of prevention already known to be successful
  • Understanding of the extent, form, and role of oppression within sexual relationships
  • Better utilisation of community-based research to produce speedier and better informed interventions and programmes.